Gale Catharine R, Baylis Daniel, Cooper Cyrus, Sayer Avan Aihie
MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK,
Age (Dordr). 2013 Dec;35(6):2493-501. doi: 10.1007/s11357-013-9528-9. Epub 2013 Apr 2.
Cross-sectional studies show that higher blood concentrations of inflammatory markers tend to be more common in frail older people, but longitudinal evidence that these inflammatory markers are risk factors for frailty is sparse and inconsistent. We investigated the prospective relation between baseline concentrations of the inflammatory markers C-reactive protein (CRP) and fibrinogen and risk of incident frailty in 2,146 men and women aged 60 to over 90 years from the English Longitudinal Study of Ageing. The relationship between CRP and fibrinogen and risk of incident frailty differed significantly by sex (p for interaction terms <0.05). In age-adjusted logistic regression analyses, for a standard deviation (SD) increase in CRP or fibrinogen, odds ratios (95% confidence intervals) for incident frailty in women were 1.69 (1.32, 2.17) and 1.39 (1.12, 1.72), respectively. Further adjustment for other potential confounding factors attenuated both these estimates. For an SD increase in CRP and fibrinogen, the fully-adjusted odds ratio (95% confidence interval) for incident frailty in women was 1.27 (0.96, 1.69) and 1.31 (1.04, 1.67), respectively. Having a high concentration of both inflammatory markers was more strongly predictive of incident frailty than having a high concentration of either marker alone. In men, there were no significant associations between any of the inflammatory markers and risk of incident frailty. High concentrations of the inflammatory markers CRP and fibrinogen are more strongly predictive of incident frailty in women than in men. Further research is needed to understand the mechanisms underlying this sex difference.
横断面研究表明，在体弱的老年人中，血液中炎症标志物浓度较高的情况往往更为常见，但这些炎症标志物是导致身体虚弱的危险因素的纵向证据却很少且不一致。我们在英国老龄化纵向研究中，对2146名年龄在60岁至90多岁的男性和女性进行了调查，研究炎症标志物C反应蛋白（CRP）和纤维蛋白原的基线浓度与发生身体虚弱风险之间的前瞻性关系。CRP和纤维蛋白原与发生身体虚弱风险之间的关系在性别上存在显著差异（交互项p<0.05）。在年龄调整的逻辑回归分析中，CRP或纤维蛋白原每增加一个标准差（SD），女性发生身体虚弱的比值比（95%置信区间）分别为1.69（1.32，2.17）和1.39（1.12，1.72）。对其他潜在混杂因素进行进一步调整后，这两个估计值均有所减弱。对于CRP和纤维蛋白原每增加一个SD，女性发生身体虚弱的完全调整后的比值比（95%置信区间）分别为1.27（0.96，1.69）和1.31（1.04，1.67）。同时具有高浓度的两种炎症标志物比仅有一种标志物浓度高更能强烈预测发生身体虚弱的情况。在男性中，任何一种炎症标志物与发生身体虚弱风险之间均无显著关联。高浓度的炎症标志物CRP和纤维蛋白原对女性发生身体虚弱的预测作用比对男性更强。需要进一步研究以了解这种性别差异背后的机制。
